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700 E Norwegian St Pottsville PA 17901-2710 | |
| (570) 621-5093 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 700 E Norwegian St, Pottsville, Pennsylvania |
| Authorized Official Name and Position | Diane N Boris (VICE PRESIDENT OF FINANCE) |
| Authorized Official Contact | 5706215093 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
700 E Norwegian St Pottsville PA 17901-2710 Ph: (570) 621-5093 | 700 E Norwegian St Pottsville PA 17901-2710 Ph: (570) 621-5093 |
| NPI Number | 1184116774 |
|---|---|
| Provider Enumeration Date | 05/31/2018 |
| Last Update Date | 05/31/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184116774 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 421001 (Pennsylvania) | Primary |
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